Impact of a latex policy on an acute NHS hospital: an audit.
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BACKGROUND: A latex policy was introduced in 1999 in a large, acute UK hospital. AIM: To audit the impact of the policy. METHOD: Semi-structured interview of the managers of 40 wards between April 2001 and July 2002. RESULTS: A policy was available on only 26 (65%) of the wards. Compliance with the policy was limited to 20 (50%) wards. CONCLUSIONS: Compliance with the policy was low in the hospital. Staff and patients are being unnecessarily exposed to the hazard of latex. (+info)
Extent and predictors of microbial hand contamination in a tertiary care ophthalmic outpatient practice.
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PURPOSE: To measure the extent of microbial hand contamination among ophthalmologists during routine clinic practice and examine its association with hand cleansing practices and beliefs, glove use, and patient load. METHODS: This was a single-masked analysis of resident and transient flora of ophthalmologists before and after patient examination and after handwashing by agar imprints of the dominant hand. Standardized questionnaires were used to collect information concerning subjects' hand cleansing practices and patient load. RESULTS: Of the 108 cultures, 107 (99.1%) were culture positive, yielding 15 separate organisms. Gram-negative bacilli were the most common transient flora, followed by Gram-positive cocci and fungi. Thirty-five (97.2%) ophthalmologists were culture positive for at least one resident and 8 (22.2%) ophthalmologists were culture positive for at least one transient organism, before patient contact. Regression models showed alcohol-based hand rub use, transient and resident floral load before patient contact, and patient load collectively accounted for 58.7% of the variance in resident floral load after patient contact. Use of alcohol-based hand rubs was associated with a mean resident floral reduction of 324.4 CFUs (95% confidence interval [CI] = 185.4 to 463.5; P < 0.01) and 31.6 CFUs (95% CI = 1.2 to 62.0; P < 0.05) after patient contact and handwashing, respectively. Handwashing with chlorhexidine was a significant predictor for transient floral load after handwashing (unstandardized beta = -17.2; 95% CI = -10.2 to -24.2; P < 0.01). CONCLUSIONS: The extent of contamination with pathogenic organisms after contact with eye outpatients, who have traditionally been perceived as relatively "clean," was of concern. Previously identified risk factors for hand contamination in inpatient settings, such as patient load, only explained a small proportion of variance in microbial load in the ophthalmic outpatient setting. (+info)
Comparing the level of dexterity offered by latex and nitrile SafeSkin gloves.
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An increase in the occurrence of latex allergy has been concurrent with the increasing use of latex gloves by laboratory and healthcare workers. In recent years nitrile gloves have been used to replace latex gloves to prevent latex allergy. Nitrile gloves offer a comparable level of protection against chemical and biological agents and are more puncture resistant. However, if manual dexterity is compromised by nitrile gloves to a greater degree than latex then this may increase the risk of sharps injuries. The Purdue pegboard test, which measures both gross and fine finger dexterity, was used to test the dexterity levels of two glove types used at HPA CEPR; Kimberly-Clark SafeSkin nitrile and latex laboratory gloves. There was a statistically significant 8.6% increase in fine finger dexterity provided by latex compared with nitrile SafeSkin laboratory gloves but no difference in gross dexterity between the glove types. There was no significant relationship between glove dexterity and age or gender. The selection of glove size was influenced by the digit length of participants. Moreover, those with longer, thinner fingers appeared to have an advantage when using nitrile SafeSkin gloves. The level of dexterity provided by latex and nitrile SafeSkin gloves for tasks on a gross dexterity level are comparable and health workers will benefit from the non-allergenic properties of nitrile. For tasks requiring fine finger dexterity nitrile SafeSkin gloves may impede dexterity. Despite this, the degree of restriction appears to have a negligible impact on safety in this study when compared with the risk of latex sensitization and subsequent allergy. In addition to glove material, working practices must also take into account glove size, fit, grip and thickness, as these factors can all influence dexterity. (+info)
Latex allergy: a follow up study of 1040 healthcare workers.
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BACKGROUND: Natural rubber latex allergy can cause skin and respiratory symptoms The aim of this study was to evaluate the prevalence and incidence of latex related symptoms and sensitisation among a large group of healthcare workers in Trieste hospitals, followed for three years before and after the introduction of powder-free gloves with low latex release. METHODS: In the years 1997-99 the authors evaluated 1040 healthcare workers exposed to latex allergen for latex related symptoms and sensitisation by means of a questionnaire, a medical examination, skin prick tests, and IgE specific antibody assay. The second evaluation was carried out in the years 2000-02, subsequent to the changeover to a powder-free environment. RESULTS: Glove related symptoms were seen in 21.8% of the nurses (227), mostly consisting of mild dermatitis: 38 (3.6%) complaining of contact urticaria and 24 (2.3%) of asthma and/or rhinitis. These symptoms were significantly related to skin prick tests positive to latex (OR = 9.70; 95% CI 5.5 to 17) and to personal atopy (OR = 2.29; 95% CI 1.6 to 3.2). Follow up was completed in 960 subjects (92.3%): 19 new subjects (2.4%) complained of itching erythema when using gloves, but none was prick positive to latex. Symptoms significantly improved and in most cases disappeared (p<0.0001). CONCLUSIONS: Simple measures such as the avoidance of unnecessary glove use, the use of non-powdered latex gloves by all workers, and use of non-latex gloves by sensitised subjects can stop the progression of latex symptoms and can avoid new cases of sensitisation. (+info)
Our farmers at risk: behaviour and belief system in pesticide safety.
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BACKGROUND: The study was done in three villages in Nueva Ecija, Philippines. It surveys farmers' belief system and pesticide practices relative to health and safety. METHODS: Initially it used a simulated market study on willingness to pay for personal protective equipment in the form of gloves and masks. Then a combination of semi-structured, formal, informal, and key-informant interviews, as well as focus groups, and field observations was done intermittently in a span of approximately 12 years. RESULTS: The farmers perceive illness in terms of inability to function. Pesticide to them may not be a threat because (i) they are immune, (ii) it is regarded as a medicine that is needed by the plants rather than poison, and (iii) exposure is only through inhalation and ingestion not through dermal contact. Added to that, they put value on pasma, and try to prevent it at the cost of exposure to pesticides. These perceptions lead to their practices showing inadequate protection. CONCLUSION: There is the need for more health education programs that tap farmers' belief system and cognitive categories to stress the need for precautions. (+info)
Primary prevention of latex related sensitisation and occupational asthma: a systematic review.
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METHODS: Eight primary prevention intervention studies on natural rubber latex (NRL) published since 1990 were identified and reviewed. This is the largest evidence base of primary prevention studies for any occupational asthmagen. RESULTS: Review of this small and largely observational evidence base supports the following evidence statement: Substitution of powdered latex gloves with low protein powder-free NRL gloves or latex-free gloves greatly reduces NRL aeroallergens, NRL sensitisation, and NRL-asthma in healthcare workers. Evidence in support of this statement is ranked SIGN level 2+, referring to well conducted case-control or cohort studies with a low risk of confounding, bias, or chance and a moderate probability that the relationship is causal. CONCLUSION: Substitution of powdered latex gloves with low protein powder-free NRL gloves or latex-free gloves promises benefits to both workers' health and cost and human resource savings for employers. This message should be broadly disseminated beyond the hospital sector to include other healthcare settings (such as aged care facilities) as well as food service and other industries where latex gloves might be used. (+info)
Glove selection as personal protective equipment and occupational dermatitis among Japanese midwives.
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This study was conducted to 1) evaluate the personal selection and use of protective gloves against bloodborne pathogens and management of glove selection in the workplace, 2) survey the experience with occupational dermatitis and other allergic symptoms, 3) explore the relationships between occupational dermatitis experience and glove use, and 4) determine the impact of glove selection upon occupational dermatitis among midwives. Subjects were 1,150 midwives working in Japan. Participants were selected from the members of Japanese Nursing Association and 835 responded to the survey. More than 30% of respondents wore gloves only when clients had an infectious disease, 41% reported experience of occupational dermatitis, 26% associated the dermatitis with medical glove use, and 2% had a diagnosis of latex allergy. Demographic variables that were significantly associated with occupational dermatitis included history of allergic symptoms other than due to occupational exposure, age, tenure and type of working institution. Using latex gloves during administering enema, shaving, changing pads, washing perineum, receiving newborns, suctioning, and handling waste significantly increased the risk of occupational dermatitis experience compared to not using gloves. Logistic regression analysis with backward stepwise elimination revealed glove selection management, such as availability of alternative glove types, using latex gloves for washing perineum, and using latex gloves for handling waste were significant predictors of occupational dermatitis. Occupational dermatitis is a significant issue and glove use as personal protective equipment is not standardized. Some occupational dermatitis may be preventable by managing appropriate glove selection. (+info)
Intervention development in occupational research: an example from the printing industry.
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BACKGROUND: Intervention development research is an essential prerequisite of any study that attempts to determine whether specific interventions work to prevent work related injury and illness. METHODS: Focus groups (n = 5) and direct observational studies (n = 21) of printers were used to elicit key issues that would aid the development of subsequent interventions. Transcripts from these were analysed by standard qualitative methods to identify common and related themes. RESULTS: The views of managers differed significantly from those of print workers in a number of areas, and working practices did not always follow policy. The majority of printers did not perceive dermatitis to be a major problem, although many complained of dry hands. Other key results included: the lack of skin care policy in most companies; poor understanding of the nature, causes, and treatment of dermatitis; low priority of dermatitis within health and safety concerns; little or no provision of occupational health services, particularly skin checks; variability in provision of and access to appropriate skin protection; and lack of accessible washing facilities. CONCLUSIONS: As a result it was decided to evaluate the implementation of four INTERVENTIONS: provision of (1) skin checks and treatment advice; (2) gloves of the correct type and size, and use of an after-work cream; (3) information on dermatitis within the printing industry; and (4) development of best practice skin care policy. (+info)